"PERIODONTAL CLAIM SUBMISSIONS 101"

James A. Kopfensteiner, DDS  

CE credit hours: 1.25

Dental consultants are required to make benefit decisions on periodontal procedures based on submitted documentation (x-ray images, periodontal charts, clinical notes, etc.) from periodontists and general dentists. This documentation is often inadequate or incomplete, resulting in a denial or delay in payment. This presentation is designed to provide information in a claims review format on how to properly review documentation for a variety of periodontal procedures.

Upon completion, attendees will be able to:

• Understand and discuss the significance of clinical attachment loss (CAL) and probing depths (PD).

• List and describe appropriate documentation requirements for scaling and root planing, periodontal grafts, and periodontal osseous surgery.

• List and describe the criteria used in interpreting radiographic images to support various periodontal procedures codes.

JAMES A. KOPFENSTEINER, DDS is a 1989 graduate of UMKC Dental School and completed his periodontal residency at the VAMC-Milwaukee in conjunction with Marquette University Dental Graduate School and the Children’s Hospital of Wisconsin in 1994. He currently maintains a full time periodontal/implant practice in St. Peters, Missouri and is an active member of the American Academy of Periodontology. He also serves as the periodontal consultant /certified dental consultant for Delta Dental of Missouri.